Individual
MRS. JESSICA LEIGH BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC
Contact information
Practice address
42 BLUEBIRD LN, PHENIX CITY, AL 36870-4755
(386) 855-4826
Mailing address
42 BLUEBIRD LN, PHENIX CITY, AL 36870-4755
(386) 855-4826
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT003682
GA
Other
Enumeration date
01/22/2019
Last updated
11/30/2022
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